Sheila Dee Ann Harris
Brookville,Ohio
Summary
Highly analytical and fact-focused professional with extensive experience in revenue cycle management. Dedicated to driving revenue growth within the healthcare industry. Demonstrated success in developing and executing effective collections and reimbursement strategies to improve claims management and reduce inefficiency. Possessing in-depth knowledge and understanding of medical terminology, HIPAA policies/procedures, CCI edits, CMS Part D guidelines, and CPT/ICD-10 codes. Skilled at addressing and resolving complex coverage and reimbursement issues. Stay up-to-date with current trends, practices, and state regulations of billing and collections through seminars/conferences. Known for exceptional communication skills. Committed to establishing and maintaining strong working relationships with insurance companies to ensure positive patient outcomes.
Overview
18
18
years of professional experience
Work History
Credentialing/Revenue Specialist
Healthcare Claims Management
01.2023 - Current
- Coordinate and facilitates the credentialing process for appointment and reappointment of provider privileges to system practices, hospitals and related facilities
- Serve as the point of contact and liaison to providers, operations, regulators, and leadership on credentialing related matters
- Review credentialing applications for accuracy and completeness to verify provider meets credentialing criteria
- Monitor application progress and submission deadlines for credentialing or recredentialing
- Conduct follow-up to obtain required documentation, resolve identified issues, ensure timely processing, and communicate updates as needed
- Update and maintain credentialing database housing provider data and documentation
- Regularly conduct audits of the database and other related files to ensure current and accurate data
- Maintain copies of current state licenses, certificates, malpractice coverage and any other required credentialing documents
- Track expirations to ensure timely renewals
- Alert Support Services to any information regarding licensing or credentialing issues affecting reimbursement as it pertains to providers or third parties
- Assist in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to provider credentialing
Consultant
Robert Half - Management Consulting Company
01.2020 - 01.2022
- Rendered exceptional consultancy service to the Public Health Dayton Montgomery County focusing on driving departmental efficiency and productivity
Supervisor - Medical Billing
Public Health Dayton Montgomery County
01.2007 - 01.2020
- Oversaw day-to-day billing department functions, including medical coding, payment posting, and reimbursement management
- Researched denials and reprocessed/adjusted claims with correct CPT codes for maximum allowable payments
- Led, coached, and empowered billing staff on all coding policies and procedures
- Devised, developed, and implemented protocols for all departments to drive efficiency and accuracy
- Formulated and distributed monthly and yearly AR reports to all departments
- Organized and chaired training sessions to improve processes and accuracy on the front end of the EMR system focusing on reducing errors
- Addressed and responded to questions from other departments regarding billing and other related issues
- Credited with improving the billing process for health departments in collaboration with CDC and the Ohio Department of Health, resulting in reducing the financial strain of the VFC program for the state of Ohio
- Optimized departmental efficiency by analyzing, evaluating, and advising on different healthcare delivery systems
- Pivotal in streamlining processes for contracting and credentialing
- Slashed AR days from 160 days to 60
- Researched and developed all billing procedures and system requirements for Addiction Services
- Trained other Ohio health departments in billing, contracting and credentialing all insurances
Education
BA - Healthcare Management
Western Governors University
Salt Lake City, Utah07.2022
Skills
- Contracting & Credentialing
- AR & Claim Management
- Guidelines/Regulations Research
- Healthcare Systems Implementation
- Accounting & Financial Operations
- Policies & Procedures Development
- Process Improvement
- Staff Training & Leadership
- Issues & Problem Resolution
- Auditing procedures
- Salesforce proficiency
- Budget planning
Career Note
- Billing Representative | Medical Account Services
- Account Manager | Demirjian Nephrology and Pain Management
- Biller | Indian Creek Family Health Center
- Patient Account Supervisor | MBI Solutions
Timeline
Credentialing/Revenue Specialist
Healthcare Claims Management
01.2023 - Current
Consultant
Robert Half - Management Consulting Company
01.2020 - 01.2022
Supervisor - Medical Billing
Public Health Dayton Montgomery County
01.2007 - 01.2020
BA - Healthcare Management
Western Governors University
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